Nasal polyps are an outgrowth of sinus linings that protrude into the nasal cavities, and are the result of nasal allergy infection and other causes of nasal obstruction, which interrupts the normal function of the sinuses. The nasal blockage caused by polyps further impairs the passage of air through the nasal passages leading to infection, snoring, loss of taste, and disorders of sleep. Furthermore, the nose and sinuses are vital anatomical parts to breathing: they allow incoming air to be warmed, cleaned, and moisturized for transport into the lungs. Therefore, removal of nasal polyps by surgical intervention eliminates obstruction and restores nasal and sinus function. This is critical to respiratory health.
Because removal of polyps, most of which originate in the deep recesses of the nose, demands utilization of a surgical operating team and appropriate anesthesia in a surgical suite, the procedure is costly, inconvenient and associated with the usual post-operative problems such as bleeding, infection, pain, slow recovery and anesthetic side effects.
The present surgical procedure for nasal polyp removal in a blind area is to identify the size and origin of the polyp using an endoscope (light source and lens viewing) and, after stabilizing the tissue to be removed, use a cutting device, ligature and/or cautery to free the protruding lesion from its base, stop bleeding, and extract the polyp from the cavity with a surgical snare. The tissue removal requires several surgical procedures: endoscopy, tissue removal and hemostasis with different instruments prior to extraction of the tissue. Each of these procedures involves time and tissue manipulation utilizing instruments that are single-purpose tools. They cannot be used jointly and, because of the size of the operative field, they need to be used one after another for the planned surgery. In fact, during the tissue removal process, each instrument must be available simultaneously for quick, effective, trouble-free extraction. The presence of post operative bleeding which demands nasal packing is the most troublesome complication for patient and surgeon.
Systems currently in practice almost exclusively remove the nasal polyp by cutting and cauterizing the base which demands use of a surgical suite and anesthesia. No workable substitute system including the use of a non-surgical technique such as ligature application for compression of the polyp base exists.
Since the origin of most nasal polyps is within the sinus cavity, not the nose, the base of the polyp tissue is difficult to identify and encircle. Tying a surgical knot in the small recesses of the nose where most polyps originate is cumbersome and ineffective leading to complications. Instruments that rely on a circular surgical loop for delivery of a ligature at the mouth or ostium of the sinus cannot reach the base of the polyp tissue for removal. For these reasons previously designed instruments for nasal polyp removal by ligature compression of the base of the polyp have not been successful and are not in general use.
Accordingly, there is a need for methods and instruments that address the above mentioned problems and can provide a simple, convenient and rapid approach to this medical procedure. This approach would allow, in most situations, the physician, not necessarily a surgeon, the use of a private medical office rather than a hospital operating suite. It would eliminate the use of an anesthetic and thus eliminate many of the complications of the current procedure providing safety and patient comfort at a fraction of the cost.